Cengage Learning - Chapter 11 Case Study: Low Serum Vitamin D
Case:
Joan is a 70-year-old Caucasian woman who has recently been diagnosed with osteoporosis after a fall during which her hip broke. She is 64 inches tall and weighs 115 pounds. Lately she has been reporting muscle pain in her legs. She eats a limited diet owing to a chronic low appetite. A recent blood test shows that Joan's serum vitamin D level is below normal. Her daily diet includes juice or fruit and toast with butter for breakfast, cottage cheese and fruit for lunch, and salad or a frozen vegetable with meat or poultry for dinner. She dislikes most fish, except canned tuna, and she often drinks a glass of fortified milk before going to bed at night. Although she lives in New Mexico, she spends most days indoors. Joan has been taking a blood-thinning medication since she was discharged from the hospital. She has been taking a daily multivitamin that contains 5000 IU of vitamin A and 400 IU of vitamin D for many years.
Joan has been taking a multivitamin supplement every day that provides 1,500 µg of vitamin A. The RDA for Vitamin A for a woman of Joan's age is 700 ug/day and the Upper Limit (UL) for vitamin A is 3000 ug/day. Joan's supplement supplies what percent of the RDA for Vitamin A? a. 214 b. 330 c. 500 d. 50 e. 100
⭐ a. 214 (700/100)*1,500=214
Because Joan is concerned about skin cancer, she uses a sunscreen when she is outside. At what SPF level will sunscreen start to interfere with vitamin D synthesis? a. 2 b. 8 c. 16 d. 32
⭐ b. 8
Which of the following food groups is rich in vitamin K? a. Freshwater fish b. Ground beef c. Dark green, leafy vegetables d. Lunch meats e. Poultry Hide Feedback
⭐ c. Dark green, leafy vegetables
If Joan wants to increase her intake of vitamin A, which of the following foods would be best? a. Broccoli b. Watermelon c. Sweet potatoes d. Tofu e. Poultry
⭐ c. Sweet potatoes
Joan's low serum vitamin D levels and low dietary vitamin D intake indicate that she is vitamin D-deficient. She needs a vitamin D supplement to raise blood vitamin D levels and to lower the risk of fractures. Based on her vitamin D Recommended Dietary Allowance, or RDA, what supplement dose should she take daily? a. 200 IU b. 400 IU c. 600 IU d. 800 IU e. 1000 IU
⭐ d. 800 IU
Of the foods Joan eats, which is the best source of vitamin D? a. Meat b. Poultry c. Vegetables d. Fortified milk e. Fruit
⭐ d. Fortified milk
Analyzing Joan's diet and supplement use, what might explain why she now has osteoporosis? a. She occasionally drinks 1 cup of vitamin D-fortified milk per day. She needs at least 3 cups of dairy per day. b. Her intake of vitamin D is inadequate to meet her needs of 20 µg per day. c. She spends most of her time indoors d. Her low vitamin D and calcium intakes and her history of taking a multivitamin pill containing 5000 IU of vitamin A per day can all lead to the development of osteoporosis. e. Her blood levels of vitamin D are low.
⭐ d. Her low vitamin D and calcium intakes and her history of taking a multivitamin pill containing 5000 IU of vitamin A per day can all lead to the development of osteoporosis.
Which of the following is NOT a likely cause of vitamin D deficiency in the elderly? a. Diminished capacity of the skin, liver, and kidneys to make and activate vitamin D b. Consumption of little or no milk c. Spending most of the time indoors d. Reduced absorption of magnesium e. Wearing protective clothing and using sunscreen while outdoors
⭐ d. Reduced absorption of magnesium. Adequate levels of magnesium in the body are essential for the absorption and metabolism of vitamin D and calcium.
